Nearly half of adolescent women (46%) report feelings of dissatisfaction when it comes to their bodies or appearance, according to a 2013 estudiar [1]. Another estudiar cited by the National Organization of Women reports that this number rises as high as 78% for girls by age 17. These statistics are alarming since body dissatisfaction se ha vinculado to eating disorders, depression, obesity, and other mental health issues [2]. Additionally, amenorrea (the absence of a period, which often co-occurs with eating disorders and/or ejercicio excesivo) poses a serious threat to a woman’s overall well-being. The healthy hormonal fluctuations of each cycle help a woman’s body systems, including her nervous, immune, cardiovascular, and reproductive systems, to function properly.
I battled an eating disorder throughout my teenage years. In fact, my empathy for individuals who struggle with body dissatisfaction led me to pursue a career in clinical mental health counseling, with a focus on women’s health and eating disorders. Since I shared my story publicly for the first time, several parents have asked how to help their struggling daughters. Recognizing that each person and situation is unique, here are a few things that either helped me as I recovered from my experience of disordered eating, body dysmorphia, and amenorrhea, or that I learned as I prepared for a career in counseling.
Eating disorder definitions
Eating disorders are varied and while some are more commonly known, others may be less familiar.
Anorexia nervosa
Anorexia nervosa es characterized by restricted food intake that results in significantly low body weight, as well as an intense fear of weight gain and body image dysmorphia [3]. In up to 84% of cases of anorexia nervosa, women will experience amenorrhea, and 11% of women will experience oligomenorrhea (inconsistent periods).
Bulimia nervosa
Bulimia nervosa is characterized by recurrent sessions of binge eating, or consuming definitively more than is typical in a two-hour period, and feeling out of control when eating. Binge eating is then followed by compensatory purging behaviors such as vomiting or overexercising [3]. Women with bulimia nervosa will experience amenorrhea approximately 40% of the time, and oligomenorrhea up to 64% of the time.
Binge eating disorder
Binge eating disorder has the same characteristics as bulimia nervosa, except there are no purging behaviors after binge eating [3].
ARFID
ARFID is a feeding disturbance that causes significant weight loss, malnutrition, and dependence on nutritional supplements, as well as impacts psychosocial functioning, but cannot be explained by other medical conditions or cultural practices [3].
Body dysmorphia
Body dysmorphia is often comorbid with the above disorders, and is characterized by a preoccupation with physical appearance, frequently “checking” or grooming oneself, and misjudgements and distress over one’s size or appearance [3].
How to respond when your child is showing signs of an eating disorder
If you think your daughter is exhibiting signs of an eating disorder (such as avoiding certain food groups, overexercising, repeatedly commenting on her appearance, immediately going to the restroom after meals, or her period stops), it is absolutely worth having a conversation with her. While these signs do not guarantee that she has an eating disorder, their presence might mean she is more prone to falling into disordered eating. Either way, talking with her is important.
If you find out that she is struggling, it’s important to keep the following four points in mind as you begin helping her (note: the level of “helping” should be determined by a doctor. They will be able to provide greater insight about the appropriate level of care).
#1. Remember: nobody quiere to have an eating disorder
A common misperception is that people with eating disorders are “choosing” their behaviors or “want” to engage in them. While there is always a degree of freedom in the choices we make, it is important to understand that eating disorders impair this freedom.
A common misperception is that people with eating disorders are “choosing” their behaviors or “want” to engage in them. While there is always a degree of freedom in the choices we make, it is important to understand that eating disorders impair this freedom.
If the disorder involves restricting food intake, family members often say to “just eat more.” While “just eat more” might seem like a sensible solution to anyone who hasn’t had an eating disorder, being told to “just eat” is about the equivalent of telling someone suffering severe depression to “just get over it,” which feels like an insurmountable task to someone struggling with an eating disorder. In other words, what seems like stubborn resistance from your daughter is really a sign of a deeper need that is not being met.
#2. Consider the root of the eating disorder
Modern psychology tells us that most disordered behaviors are actually a symptom of a deeper issue or unmet need. With this in mind, a helpful question to consider yourself (or ask your daughter) is what the root of the eating disorder might be.
I ran cross country in middle school and I went through puberty early. Unfortunately, I believed that my developed body was hindering my athletic performance. This false belief fueled my body dissatisfaction. In sixth grade, I didn’t understand that eating less would no affect how wide my hips were or how developed my breasts were. I thought that if I made my body look like the skinny girls, I would run faster. This didn’t work, and my false perceptions became beliefs that reinforced my behaviors.
I truly believed that because skinny girls would win races, “skinny girls are better than me.” My eleven-year-old brain concluded “maybe if I’m skinny, I’ll be fast and more people will like me.” Even if a parent means well by encouraging their daughter to eat, being told to “just eat” doesn’t solve the root issue of feeling inadequate or desiring affirmation from peers and coaches. If anything, it might reinforce her negative beliefs.
#3. Consider the environmental factors reinforcing negative body image and beliefs
Considering the environmental factors that could be reinforcing false beliefs is also important, especially among adolescents who are unduly influenced by peers. If your daughter’s friends are thinking and talking about being skinny, losing weight, or achieving a certain body type, it’s very possible that your daughter will start thinking more about this too. While increased peer group interaction and acceptance is a critical part of adolescent development, a consequence of it is that teens are more susceptible to comparison. This, coupled with the heightened sense of self-awareness that begins around ages 8-10, leaves girls particularly vulnerable to feelings of self-consciousness when they notice that their bodies look different from their peers [6].
It doesn’t help that we also live in a culture that values female leanness, where women are constantly exposed to ideas about the “ideal body type.” You might consider whether your daughter is being exposed to ideas or messages that could harm her self-image. Did someone make a comment about her appearance? Has she been exposed to the idea that “bodies are better” if they are a certain size or perform in a certain way (this includes hearing parents make comments about their weight or about certain food groups)? Is she seeing social media content on dieting or fasting? Is she playing a sport that values leanness (like distance running, gymnastics, or dancing)? Even a seemingly minimal exposure to one of these things can be enough to suggest that her body isn’t perfect.
Of course, this doesn’t mean that eliminating all causes of negative environmental exposure is the solution (in fact, it’s probably not even possible!). Rather, instilling positive thoughts about our bodies and reinforcing these ideas will equip your daughter to encounter, assess, and respond to the messages about body image that she will continue receiving for the rest of her life.
Of course, this doesn’t mean that eliminating all causes of negative environmental exposure is the solution (in fact, it’s probably not even possible!). Rather, instilling positive thoughts about our bodies and reinforcing these ideas will equip your daughter to encounter, assess, and respond to the messages about body image that she will continue receiving for the rest of her life.
#4. Know the ways you are best suited to help
As with many sensitive topics, creating an atmosphere of respect and positivity about our bodies goes a long way toward reducing negative self-image. This is helpful not only for teens, but also for younger children as you strive to build up their self image. Remind children that every body is different and not to comment on people’s appearance. Change the focus of conversation from calories and weight, “good” and “bad” food, or how much someone eats, to conversations about fueling our bodies, appreciating the ways they serve us, and eating nutritious foods to support our energy needs (I still remember my dad encouraging me to “feed the machine,” a mantra that stuck with me as I recovered and got back into distance running).
If you suspect (or know) that your child is struggling with body dysmorphia or an eating disorder, approach conversations gently, with sincerity and empathy. Remember that your child does not desea to have an eating disorder, and that framing conversations so that she understands you are on her team is critical. If she feels like you are not on her team, it will only become more challenging to actually reach her.
Additionally, putting together a recovery team is very important. Depending on the level of severity, this could include a counselor, pediatrician, dietician, or psychiatrist. In my experience, being at the upper end of “underweight,” I was able to work closely with a counselor and my pediatrician to make lifestyle modifications and regain weight. My parents helped prepare my portions and packed my lunches to help me think less about calories. But for those who are more underweight, an in-patient setting or more in depth care might be necessary. Consulting a doctor or mental health professional can be very helpful in making this determination!
The psychology behind eating disorder treatment approaches
Some practitioners emphasize the pursuit of physical healing before beginning the process of healing mentally. This approach is based on the reality that malnourishment impedes the hormones that stabilize mood and energy levels, which can worsen comorbid psychological issues. However, this approach sometimes results in practitioners focusing exclusively on correcting eating behaviors, and very little on the psychological issues or the thought patterns motivating the behaviors.
While physical recovery is critical for long-term health, it is important to also be attentive to psychological needs as well. A combined approach (which is what my therapist used for my treatment) focuses on teaching healthy eating behaviors, while also challenging the thoughts that lead someone to undereat. This approach helped me to heal both physically and psychologically at the same time.
(Note: While the treatment approach used should ultimately be determined by a professional, as a parent, it is helpful to be aware of the physical and psychological components of eating disorders. This can help you—and other people in your daughter’s life—to be intentional when supporting her or discussing treatment with her. While there is no one-size-fits-all approach to eating disorder treatment, it is important to remember that we are embodied beings with emotional, mental, and spiritual needs, and tending to needs in all of these areas will lead to the greatest flourishing!)
While there is no one-size-fits-all approach to eating disorder treatment, it is important to remember that we are embodied beings with emotional, mental, and spiritual needs, and tending to needs in all of these areas will lead to the greatest flourishing!)
Menstrual cycle charting can be a powerful tool in eating disorder recovery
Finally, I would be remiss not to mention another major contributor to my recovery: learning about my menstrual cycle and how to track and chart it. When I first lost my period (as many—if not most—young women do when they are undereating), I didn’t understand the harm this was causing in my body by increasing my chances of osteoporosis, harming my mental health, and hindering my athletic performance. But as I learned about the menstrual cycle and how I could work con my body by charting my cycle, my self-respect and desire to care for my body only increased.
In fact, I began to see my cycle as a sort of super-power, which not only meant I was healthy enough to have a baby one day, but that it increased my capacity for certain activities at different times of the month. The high “estrogen days” leading up to ovulation meant I was more social and outgoing, and also more capable of crushing a speed workout. During my fase lútea, on the other hand, I was more reflective and capable of completing long-term projects. Understanding the way my body works in a state of health made me want to support it, which naturally helped lead to healing from my eating disorder.
A final word of encouragement
Whether it is you, your daughter, or someone else you know who is struggling with an eating disorder, know that recovery is possible! It takes a lot of effort, patience, and resilience, but with the right support team, it is possible to regain both physical and mental health. The first step is recognizing that you need help, and the second is deciding to do something about it! I encourage you to take that step, and trust that you can have great hope for a bright future ahead.